Skip to main content
Erschienen in: Obesity Surgery 11/2011

01.11.2011 | Clinical Research

Factors Related to Weight Loss up to 4 Years after Bariatric Surgery

verfasst von: Wilson Salgado Júnior, Júlia Lopes do Amaral, Carla Barbosa Nonino-Borges

Erschienen in: Obesity Surgery | Ausgabe 11/2011

Einloggen, um Zugang zu erhalten

Abstract

Background

Gastric bypass is the bariatric surgery most frequently performed in the world. It is responsible for sustainable weight loss, resolution of comorbidities, and improvement of quality of life. However, weight loss is not homogeneous, at times being insufficient in some patients. Our objective was to assess which factors were important in influencing this differentiated weight loss over a period of 4 years after surgery.

Methods

In this retrospective study, we assessed several physical, socioeconomic, behavioral, surgical, and demographic factors in morbidly obese patients submitted to Roux-en-Y gastric bypass that might influence excess weight loss over a period of 4 years after surgery. The same factors were assessed in order to characterize insufficient excess weight loss (<50% EWL).

Results

Review of the medical records of 149 patients showed that type-2 diabetes mellitus and dyslipidemia were the most important factors related to a lower EWL up to the third year. Preoperative weight loss, lower schooling, and lack of adherence to nutritional guidelines were important after 2 and 3 years. The presence of depression and lack of adherence to nutritional guidelines were the factors related to EWL of less than 50%.

Conclusions

Special attention and clarification should be provided to patients with diabetes mellitus type 2 and dyslipidemia and to patients with depression and lower schooling, since these patients tend to lose less excess weight after surgery. Multiprofessional care should also be provided so that the patients will follow nutritional guidelines more rigorously after surgery.
Literatur
1.
Zurück zum Zitat Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.PubMedCrossRef Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.PubMedCrossRef
2.
Zurück zum Zitat Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRef Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRef
3.
4.
Zurück zum Zitat Ali MR, Fuller WD, Choi MP, et al. Bariatric surgical outcomes. Surg Clin North Am. 2005;85:835–52.PubMedCrossRef Ali MR, Fuller WD, Choi MP, et al. Bariatric surgical outcomes. Surg Clin North Am. 2005;85:835–52.PubMedCrossRef
5.
Zurück zum Zitat Salem L, Jensen CC, Flum DR. Are bariatric surgical outcomes worth their cost? A systematic review. J Am Coll Surg. 2005;200:270–8.PubMedCrossRef Salem L, Jensen CC, Flum DR. Are bariatric surgical outcomes worth their cost? A systematic review. J Am Coll Surg. 2005;200:270–8.PubMedCrossRef
6.
Zurück zum Zitat Nguyen NT, Goldman C, Rosenquist CJ, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg. 2001;234(3):279–91.PubMedCrossRef Nguyen NT, Goldman C, Rosenquist CJ, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg. 2001;234(3):279–91.PubMedCrossRef
7.
Zurück zum Zitat Pories WJ, Swanson MS, MacDonald KG, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995;222:339–50.PubMedCrossRef Pories WJ, Swanson MS, MacDonald KG, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995;222:339–50.PubMedCrossRef
8.
Zurück zum Zitat Christou NV, Look D, MacLean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244:734–40.PubMedCrossRef Christou NV, Look D, MacLean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244:734–40.PubMedCrossRef
9.
Zurück zum Zitat Elfhag K, Rössner S. Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obesity reviews. 2005;6:67–85.PubMedCrossRef Elfhag K, Rössner S. Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obesity reviews. 2005;6:67–85.PubMedCrossRef
10.
Zurück zum Zitat Ciovica R, Takata M, Vittinghoff E. The Impact of Roux Limb Length on Weight Loss After Gastric Bypass Obes Surg. 2008;18:5–10. Ciovica R, Takata M, Vittinghoff E. The Impact of Roux Limb Length on Weight Loss After Gastric Bypass Obes Surg. 2008;18:5–10.
11.
Zurück zum Zitat Campos GM, Rabl C, Mulligan K, et al. Factors associated with weight loss after gastric bypass. Arch Surg. 2008;143:877–84.PubMedCrossRef Campos GM, Rabl C, Mulligan K, et al. Factors associated with weight loss after gastric bypass. Arch Surg. 2008;143:877–84.PubMedCrossRef
12.
Zurück zum Zitat Carbonell AM, Wolfe LG, Meador RN, et al. Does diabetes affect weight loss after gastric bypass? Surg Obes Relat Dis. 2008;4:441–4.PubMedCrossRef Carbonell AM, Wolfe LG, Meador RN, et al. Does diabetes affect weight loss after gastric bypass? Surg Obes Relat Dis. 2008;4:441–4.PubMedCrossRef
13.
Zurück zum Zitat Roberts K, Duffy A, Kaufman J, et al. Size matters: gastric pouch size correlates with weight loss after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2007;21:1397–402.PubMedCrossRef Roberts K, Duffy A, Kaufman J, et al. Size matters: gastric pouch size correlates with weight loss after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2007;21:1397–402.PubMedCrossRef
14.
Zurück zum Zitat Lutfi R, Torquati A, Sekhar N, et al. Predictors of success after laparoscopic gastric bypass: a multivariate analysis of socioeconomic factors. Surg Endosc. 2006;20:864–7.PubMedCrossRef Lutfi R, Torquati A, Sekhar N, et al. Predictors of success after laparoscopic gastric bypass: a multivariate analysis of socioeconomic factors. Surg Endosc. 2006;20:864–7.PubMedCrossRef
15.
Zurück zum Zitat Ray EC, Nickels MW, Sayeed S, et al. Predicting success after gastric bypass: the role of psychosocial and behavioral factors. Surgery. 2003;134:555–63.PubMedCrossRef Ray EC, Nickels MW, Sayeed S, et al. Predicting success after gastric bypass: the role of psychosocial and behavioral factors. Surgery. 2003;134:555–63.PubMedCrossRef
16.
Zurück zum Zitat Perugini RA, Mason R, Czerniach DR, et al. Predictors of complication and suboptimal weight loss after laparoscopic Roux-en-Y gastric bypass. Arch Surg. 2003;138:541–6.PubMedCrossRef Perugini RA, Mason R, Czerniach DR, et al. Predictors of complication and suboptimal weight loss after laparoscopic Roux-en-Y gastric bypass. Arch Surg. 2003;138:541–6.PubMedCrossRef
17.
Zurück zum Zitat Kadera BE, Lum K, Grant J. Remission of type 2 diabetes after Roux-en-Y gastric bypass is associated with greater weight loss. Surg Obes Relat Dis. 2009;5:305–9.PubMedCrossRef Kadera BE, Lum K, Grant J. Remission of type 2 diabetes after Roux-en-Y gastric bypass is associated with greater weight loss. Surg Obes Relat Dis. 2009;5:305–9.PubMedCrossRef
18.
Zurück zum Zitat Melton GB, Steele KE, Schweitzer MA, et al. Suboptimal weight loss after gastric bypass surgery: correlation of demographics, comorbidities and insurance status with outcomes. J Gastrointest Surg. 2008;12:250–5.PubMedCrossRef Melton GB, Steele KE, Schweitzer MA, et al. Suboptimal weight loss after gastric bypass surgery: correlation of demographics, comorbidities and insurance status with outcomes. J Gastrointest Surg. 2008;12:250–5.PubMedCrossRef
19.
Zurück zum Zitat Luis DA, Aller R, Sagrado MG, et al. Influence of Lys656asn polymorphism of leptin receptor gene on surgical results of biliopancreatic diversion. J Gastrointest Surg. 2010;14:899–903.PubMedCrossRef Luis DA, Aller R, Sagrado MG, et al. Influence of Lys656asn polymorphism of leptin receptor gene on surgical results of biliopancreatic diversion. J Gastrointest Surg. 2010;14:899–903.PubMedCrossRef
20.
Zurück zum Zitat Thonney B, Pataky Z, Badel S, et al. The relationship between weight loss and psychosocial functioning among bariatric surgery patients. Am J Surg. 2010;199:183–8.PubMedCrossRef Thonney B, Pataky Z, Badel S, et al. The relationship between weight loss and psychosocial functioning among bariatric surgery patients. Am J Surg. 2010;199:183–8.PubMedCrossRef
21.
Zurück zum Zitat Livhits M, Mercado C, Yermilov I, et al. Does weight loss immediately before bariatric surgery improve outcomes: a systematic review. Surg Obes Relat Dis. 2009;5:713–21.PubMedCrossRef Livhits M, Mercado C, Yermilov I, et al. Does weight loss immediately before bariatric surgery improve outcomes: a systematic review. Surg Obes Relat Dis. 2009;5:713–21.PubMedCrossRef
22.
Zurück zum Zitat NIH. Gastrointestinal surgery for severe obesity: Consensus Development Conference Panel. Ann Intern Med. 1991;115:956–61. NIH. Gastrointestinal surgery for severe obesity: Consensus Development Conference Panel. Ann Intern Med. 1991;115:956–61.
23.
Zurück zum Zitat Ma Y, Pagoto SL, Olendzki BC, et al. Predictors of weight status following laparoscopic gastric bypass. Obes Surg. 2006;16:1227–31.PubMedCrossRef Ma Y, Pagoto SL, Olendzki BC, et al. Predictors of weight status following laparoscopic gastric bypass. Obes Surg. 2006;16:1227–31.PubMedCrossRef
24.
Zurück zum Zitat Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y – 500 patients: technique and results, with 3–60 month follow-up. Obes Surg. 2000;10:233–9.PubMedCrossRef Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y – 500 patients: technique and results, with 3–60 month follow-up. Obes Surg. 2000;10:233–9.PubMedCrossRef
25.
26.
27.
Zurück zum Zitat Prospective UK. Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837–53. published correction appears in Lancet. 1999;354(9178):602.CrossRef Prospective UK. Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837–53. published correction appears in Lancet. 1999;354(9178):602.CrossRef
28.
Zurück zum Zitat Roberts K, Duffy A, Kaufman J, et al. Size matters: gastric pouch size correlates with weight loss after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2007;21:1397–402.PubMedCrossRef Roberts K, Duffy A, Kaufman J, et al. Size matters: gastric pouch size correlates with weight loss after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2007;21:1397–402.PubMedCrossRef
29.
Zurück zum Zitat Brolin RE, Kenler HA, Gorman JH, et al. Long-limb gastric bypass in the superobese. A prospective randomized study. Ann Surg. 1992;215:387–95.PubMedCrossRef Brolin RE, Kenler HA, Gorman JH, et al. Long-limb gastric bypass in the superobese. A prospective randomized study. Ann Surg. 1992;215:387–95.PubMedCrossRef
30.
Zurück zum Zitat Ciovica R, Takata M, Vittinghoff E. The impact of Roux limb length on weight loss after gastric bypass. Obes Surg. 2008;18:5–10.PubMedCrossRef Ciovica R, Takata M, Vittinghoff E. The impact of Roux limb length on weight loss after gastric bypass. Obes Surg. 2008;18:5–10.PubMedCrossRef
31.
Zurück zum Zitat van de Laar A, de Caluwé L, Dillemans B. Relative Outcome Measures for Bariatric Surgery. Evidence against excess weight loss and excess body mass index loss from a series of laparoscopic Roux-en-Y gastric bypass patients. Obes Surg. 2011. doi:10.1007/s11695-010-0347-0. van de Laar A, de Caluwé L, Dillemans B. Relative Outcome Measures for Bariatric Surgery. Evidence against excess weight loss and excess body mass index loss from a series of laparoscopic Roux-en-Y gastric bypass patients. Obes Surg. 2011. doi:10.​1007/​s11695-010-0347-0.
32.
Zurück zum Zitat Scopinaro N, Adami GF, Papadia FS. Effects of biliopancreatic diversion on type 2 diabetes in patients with BMI 25 to 35. Ann Surg. 2011;253(4):699–703. Scopinaro N, Adami GF, Papadia FS. Effects of biliopancreatic diversion on type 2 diabetes in patients with BMI 25 to 35. Ann Surg. 2011;253(4):699–703.
Metadaten
Titel
Factors Related to Weight Loss up to 4 Years after Bariatric Surgery
verfasst von
Wilson Salgado Júnior
Júlia Lopes do Amaral
Carla Barbosa Nonino-Borges
Publikationsdatum
01.11.2011
Verlag
Springer-Verlag
Erschienen in
Obesity Surgery / Ausgabe 11/2011
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-011-0420-3

Weitere Artikel der Ausgabe 11/2011

Obesity Surgery 11/2011 Zur Ausgabe

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

Real-World-Daten sprechen eher für Dupilumab als für Op.

14.05.2024 Rhinosinusitis Nachrichten

Zur Behandlung schwerer Formen der chronischen Rhinosinusitis mit Nasenpolypen (CRSwNP) stehen seit Kurzem verschiedene Behandlungsmethoden zur Verfügung, darunter Biologika, wie Dupilumab, und die endoskopische Sinuschirurgie (ESS). Beim Vergleich der beiden Therapieoptionen war Dupilumab leicht im Vorteil.

Vorsicht, erhöhte Blutungsgefahr nach PCI!

10.05.2024 Koronare Herzerkrankung Nachrichten

Nach PCI besteht ein erhöhtes Blutungsrisiko, wenn die Behandelten eine verminderte linksventrikuläre Ejektionsfraktion aufweisen. Das Risiko ist umso höher, je stärker die Pumpfunktion eingeschränkt ist.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.